AIM:To investigate the visual development of children under 6 years old in Wuhan, and provide evidence-based support for the formulation and optimization of regional policies for children's eye health care.METHODS:Suresight refractive screener was applied to rapid refractive status examination in 4 989 preschool children under 6 years old in Wuhan City, with results determined according to the manufacturer's age-specific referral criteria. All screened pre-school children completed vision screening and comprehensive ophthalmic examination.RESULTS: A total of 4 989 children under 6 years old were screened out, including 2 641 males and 2 348 females. They were divided into 6 groups according to age: 426 aged from 6-month to 1-year-old, 903 aged >1 to 2 years old, 1 078 aged >2 to 3 years old, 442 aged >3 to 4 years old, 808 aged >4 to 5 years old, and 1 332 aged >5 to 6 years old. The abnormal rate in the 6-month to 1-year-old group was 44.60%, in the >1 to 2 years old group was 26.02%, in the >2 to 3 years old group was 15.58%, in the >3 to 4 years old group was 10.86%, in the >4 to 5 years old group was 21.91%, in the >5 to 6 years old group was 23.27%, and the total refractive abnormal rate for children aged 6 mo to 6 years old was 22.61%. The refractive abnormal rate generally showed a decreasing trend with increasing age(P<0.001); the refractive abnormal rate in boys aged 6-month to 6 years old was 12.33%, and in girls was 10.28%, with no statistically significant difference in the abnormal rate between boys and girls(P>0.05); among children aged 6-month to 6 years old, the abnormal rate of single-eye myopia was 0.98%, of single-eye hyperopia was 5.41%, of single-eye astigmatism was 9.92%, of binocular myopia was 0.98%, of binocular hyperopia was 2.79%, and of binocular astigmatism was 8.14%; the prevalence of astigmatism in children aged 6-month to 1-year-old was 40.38%, in those aged >1 to 2 years old was 19.82%, in those aged >2 to 3 years old was 12.34%, in those aged >3 to 4 years old was 9.05%, in those aged >4 to 5 years old was 18.81%, and in those aged >5 to 6 years old was 16.89%; the prevalence of astigmatism in children aged 6-month to 6 years old was 18.06%. The abnormal rate of astigmatism in the four age groups ranging from 6-month to 4 years old decreased continuously with age(P<0.001). There was no statistically significant difference in the abnormal rate of astigmatism between the >4 to 5 years old group and the >5 to 6 years old group(P>0.05).CONCLUSION:Refractive error has become a common eye disease among preschool children. Through early vision screening, establishing a systematic refractive management file, and early intervention, the best treatment period can be seized to avoid missing it and causing adverse consequences.

OBJECTIVE To investigate the correlation of component content with colorimetric values during the roasting process of Ziziphus jujuba ， and to provide criteria for discriminating the roasting degree of Z. jujuba . METHODS Samples were prepared by dry stir-frying for different roasting times. The eight main components in raw Z. jujuba and the samples stir-fried for different roasting times-namely adenosine， magnoflorine， jujuboside A， spinosin， 6-feruloylspinosin， betulinic acid， oleic acid， and linoleic acid-were quantitativel y analyzed using ultra-performance liquid chromatography. The chromaticity values were determined using a UV spectrophotometer. The correlation and differences between the chromaticity values of Z. jujuba at different roasting times and their components content were analyzed by Pearson correlation analysis， linear regression analysis， principal component analysis （PCA） ， cluster heatmap analysis （CHA）， and partial least squares discriminant analysis （PLS-DA） to clarify the processing endpoint. RESULTS As the roasting time increased， the contents of linoleic acid and oleic acid decreased， while the contents of other components exhibited an increasing trend. Concurrently， the colorimetric value L* and E*ab were observed to decline， whereas the a* value demonstrated a gradual increase. Pearson correlation analysis revealed that L* and E*ab exhibited a significant negative correlation with the contents of adenosine， spinosin， 6-feruloylspinosin， jujuboside A， betulinic acid and magnoflorine （ P ＜0.05）. The results of linear regression analysis indicate that the content of six components, including adenosine， in the medicinal material can be preliminarily predicted by analyzing the colorimetric values of Z. jujuba powder. PCA and CHA successfully classified raw and stir-fried samples. The PLS-DA results indicated that L*， E*ab， a*， linoleic acid content， and oleic acid content were the main parameters that differentiated the color and quality of Z. jujuba at different roasting times. After frying for 9 to 10 minutes， the colorimetric values L* and E*ab decreased to their minimum values and stabilized， while a* remained consistently high with little variation；simultaneously， the concentrations of the six major components， excluding linoleic acid and oleic acid， reached their peak levels. CONCLUSIONS A significant correlation between the colorimetric values of Z. jujuba and the contents of six components， including adenosine， is confirmed. The optimal roasting time range is determined to be 9-10 minutes. Furthermore， the colorimetric value-component content correlation analysis method established in this study proved to be practical and applicable for discriminating the roasting degree of Z. jujuba .

ObjectiveTo investigate the independent predictive factors for 90-day mortality in patients with acute-on-chronic liver failure （ACLF）， to establish a risk predictive model， and to assess its predictive efficacy in comparison with MELD， MELD-Na， MELD 3.0， and COSSH-ACLF Ⅱ. MethodsA retrospective analysis was performed for the clinical data of 394 patients with ACLF who were admitted to The Affiliated Hospital of Inner Mongolia Medical University and Hohhot Second Hospital from July 2018 to July 2024， and general information and laboratory markers on admission were collected from all patients. The independent-samples t test or the Mann-Whitney U test was used for comparison of quantitative data between two groups， and the chi-square test or the adjusted chi-square test was used for comparison of qualitative data between two groups. The LASSO regression analysis was used to identify related variables， and the multivariate logistic regression analysis was used to establish a predictive model and generate a nomogram. The receiver operating characteristic （ROC） curve， the area under the ROC curve （AUC）， calibration curve， and clinical decision curve were used to assess the performance of the model. ResultsA total of 394 patients with ACLF were included in this study， with 136 patients in the training set， 58 in the internal validation set， and 200 in the external validation set. The cohort had a mean age of 52.9±11.7 years， among whom male patients accounted for 72.84% （287/394）， the patients with HBV infection accounted for 22.33% （88/394）， the patients with alcohol-related causes accounted for 45.94% （181/394）， and the patients with other causes （including drug-induced and autoimmune diseases） accounted for 31.73% （125/394）. The overall 90-day mortality rate was 27.41% （108/394）. The multivariate logistic regression analysis showed that diabetes （odds ratio ［OR］= 5.831， 95% confidence interval ［CI］： 1.587 — 21.424， P=0.008）， cystatin C （Cys-C） （OR=2.984， 95%CI： 1.501 — 5.933， P=0.002）， and spontaneous peritonitis （SBP） （OR=5.692， 95%CI： 2.150 — 15.071， P<0.001） were independent risk factors， and a nomogram was generated based on these factors. This model had an AUC of 0.836 in the training set， 0.881 in the internal validation set， and 0.878 in the external validation set， showing a good discriminatory ability. The calibration curve showed a good degree of fitting， with a relatively high net clinical benefit. The subgroup analysis based on etiology showed that the model had an AUC of 0.850 in the patients with HBV infection， 0.858 in the patients with alcohol-induced ACLF， and 0.908 in the patients with other etiologies， indicating that the model had a good discriminatory ability across the populations with different etiologies. Compared with traditional scores， the model （AUC=0.836） had a significantly better predictive value than MELD （AUC=0.619， Z=3.197， P=0.001）， MELD-Na （AUC=0.651， Z=2.998， P=0.003）， MELD 3.0 （AUC=0.601， Z=3.682， P<0.001）， and COSSH-ACLF Ⅱ （AUC=0.719， Z=2.396， P=0.017） alone. ConclusionDiabetes， SBP， and Cys-C are independent risk factors for 90-day mortality in patients with ACLF. Compared with MELD， MELD-Na， MELD 3.0， and COSSH-ACLF Ⅱ scores， this model has a higher predictive value for 90-day prognosis in patients with ACLF and is suitable for patients with ACLF caused by various etiologies.

Objective To compare the radiation doses to adult patients from two types of computed tomography (CT) scanners at a hospital in Shanghai City, analyze the radiation dose to patients and impact factors, and provide data for reducing radiation dose in CT examinations. Methods Radiation parameters and radiation doses to adult patients from two types of CT scanners were investigated. Adult patients aged 15-<40 years and 40-70 years who underwent head, chest, abdomen, and lumbar spine CT examinations were randomly selected to collect their scanning data. Effective doses for different scanning regions and age groups were estimated using conversion formulas and compared. Results The CT scanning data of 160 adult patients from each type of CT scanners were collected. For scanner A, the 75th percentiles of volume CT dose index (CTDI_vol) of the head, chest, abdomen, and lumbar spine were 45, 4, 7, and 6 mGy; the 75th percentiles of dose-length product (DLP) were 726, 143, 373, and 179 mGy·cm; the 75th percentiles of effective dose were 1.5, 2.0, 5.6, and 2.7 mSv. For scanner B, the 75th percentiles of CTDI_vol of the head, chest, abdomen, and lumbar spine were 54, 6, 9, and 15 mGy; the 75th percentiles of DLP were 755, 215, 502, and 428 mGy·cm; the 75th percentiles of effective dose were 1.6, 3.0, 7.4, and 6.4 mSv. Conclusion The 75th percentiles of the CTDI_vol and DLP of all scanning regions were lower than the diagnostic reference levels for both types of scanners. Except for head DLP, scanner A demonstrated significantly lower CTDI_vol and DLP values than scanner B across all regions. The 75th percentiles of effective dose for head, chest, and abdomen examinations on both scanners did not exceed the corresponding values reported for patients in Hangzhou City.

ObjectiveTo evaluate the safety and clinical utilization of traditional Chinese medicine （TCM） formula granules based on real-world data， and to provide evidence for their rational clinical use. MethodsA multicenter， prospective， open-label， observational centralized monitoring study was conducted. Participants who received TCM formula granules in 293 medical institutions throughout China from February 5th， 2020 to May 20th， 2025 were consecutively enrolled. The year of data collection was used as the stratification factor. Demographic characteristics （including sex， age， and concomitant medication use）， information on TCM formula granule use （including mean prescribed dosage and inappropriate use）， and adverse event（AE）/adverse drug reaction（ADR） occurrence and related factors were collected and statistically analyzed. ResultsA total of 42 011 participants were included in the safety set （SS）， with a mean age of （38.34±22.30） years， including 18 693 males and 23 318 females. Among them， 3519 participants （8.38%） had a history of or concomitant diseases. The three most common comorbidities were hypertension （1189 cases， 33.79%）， diabetes mellitus （850 cases， 24.15%）， and coronary heart disease （471 cases， 13.38%）. The top three diagnostic categories were respiratory， thoracic， and mediastinal diseases （7008 cases， 16.68%）， infectious and parasitic diseases （6591 cases， 15.69%）， and gastrointestinal diseases （4580 cases， 10.90%）.Among 41 961 participants with available concomitant medication data， 3332（7.94%） received concomitant medications， and western medicines were the most commonly used concomitant medications （2819 cases， 6.72%）. The mean prescribed dosage of TCM formula granules （expressed as the equivalent dosage of crude herbal pieces） was （158.23±104.86） g in 2020， （131.70±65.84） g in 2021， （130.62±59.96） g in 2022， （86.74±50.61） g in 2023， （118.59±52.01） g in 2024， and （134.38±49.43） g in 2025. The five most frequently prescribed toxic herbs were Kuxingren （Semen Armeniacae Amarum， 2746 cases， 6.54%）， Xixin （Radix et Rhizoma Asari， 2193 cases， 5.22%）， processed Kuxingren （862 cases， 2.05%）， Baiqucai （Herba Chelidonii， 747 cases， 1.78%）， and Wuzhuyu （Fructus Evodiae， 645 cases， 1.54%）. Prescriptions involving incompatible combinations of the "eighteen antagonisms" and the "nineteen mutual inhibitions" were most frequently observed in 2020 （54 cases， 0.503%）， and then decreased markedly， remaining at zero or an extremely low level thereafter. The overall incidence of adverse drug reactions （ADRs） associated with TCM formula granules was 0.057% （24 cases）， indicating a rare occurrence. The annual incidence was 0.028% （3 cases） in 2020， 0 in both 2021 and 2022， 0.065% （5 cases） in 2023， 0.158% （15 cases） in 2024， and 0.226% （1 case） in 2025. Among the 24 patients who experienced ADRs， 15 had inappropriate medication use.Five of the 24 patients used toxic herbs， and all five had inappropriate medication. Multivariate logistic regression analysis showed that no history of drug-related adverse reactions ［OR=0.053， 95%CI（0.006， 0.465）］ and no concomitant medication ［OR=0.315， 95%CI（0.109， 0.911）］ were associated with a lower risk of ADRs. ConclusionTCM formula granules are widely used in clinical practice and exhibit a favorable overall safety. Greater attention should be paid to people with a history of drug-related adverse reactions and those receiving concomitant medications to further improve medication safety.

Objective: To analyze the status of wasting among primary and secondary school students in Guangxi from 2021 to 2025, to explore the factors associated with wasting, so as to provide scientific evidence for improving student s nutrition. Methods: Based on the National Surveillance and Intervention Program on Common Diseases and Health Risk Factors among Students, a stratified cluster random sampling was adopted from 2021 to 2025 to recruit 71 077, 236 511, 243 466, 249 619 and 246 259 primary and secondary school students in Guangxi for physical examination and questionnaire survey. The χ 2 test was used for intergroup comparisons. Chi-square trend test was used to conduct trend analysis. Multilevel Logistic regression model was employed to identify factors associated with wasting. Results: The overall wasting detection rate was 11.65% during 2021-2025. Over the five year period, the rate exhibited a S shaped fluctuation pattern characterized by "decline-rise-decline" and the difference across years was statistically significant ( χ 2=230.53, P <0.05). Multilevel Logistic regression analysis showed that male students ( OR = 1.63 ), primary school students ( OR =1.53) and junior high school students ( OR =1.12), boarding students ( OR =1.08), and students with adequate sleep duration ( OR =1.12) were positively correlated with the risk of wasting (all P <0.05). Students who consumed sugar sweetened beverages ≥1 time/day ( OR =0.93), ate fresh fruit ≥1 time/day ( OR =0.95), had moderate to vigorous physical activity for more than 60 minutes per day ( OR =0.88), and had moderate to vigorous physical activity for more than 60 minutes per day on more than half of weekend days ( OR =0.88) were negatively correlated with the risk of wasting (all P <0.05). Conclusions Wasting status among primary and secondary school students in Guangxi improved between 2021 and 2025, though fluctuations persisted. Greater attention should be paid to the nutritional status of male students and boarding students. While cultivating balanced dietary habits and appropriate exercise behaviors, the complex relationship between sleep and malnutrition should also be given due consideration.

ObjectiveTo investigate the association between sarcopenia and short-term prognosis in patients with acute-on-chronic liver failure （ACLF）， to assess the value of Model for End-Stage Liver Disease （MELD）， MELD combined with serum sodium concentration （MELD-Na）， MELD 3.0， and Chinese Group on the Study of Severe Hepatitis B （COSSH）-ACLF Ⅱ score in predicting the 90-day prognosis of ACLF patients， and to analyze the predictive gain of sarcopenia over traditional prognostic scoring models. MethodsA retrospective study was conducted among 219 patients with ACLF who were hospitalized in The Affiliated Hospital of Inner Mongolia Medical University， No. 2 Hospital of Hohhot， Hohhot First Hospital， and Inner Mongolia People’s Hospital from July 2018 to July 2024. L3 skeletal muscle index （L3-SMI） was measured and calculated based on abdominal computed tomography images， and sarcopenia was diagnosed based on L3-SMI. According to 90-day prognosis， the patients with ACLF were divided into survival group with 124 patients and death group with 95 patients. The chi-square test or the Fisher’s exact test was used for comparison of categorical data between two groups； the independent samples t-test was used for comparison of normally distributed continuous data between two groups， and the Mann-Whitney U test was used for comparison of non-normally distributed continuous data between two groups. The multivariate Cox regression analysis （stepwise backward approach） was used to identify independent risk factors for 90-day mortality in ACLF patients. The Kaplan-Meier method was used for survival analysis， and the Log-rank test was used for comparison between groups. The receiver operating characteristic curve was plotted to evaluate the predictive performance of each model， and the DeLong test， bootstrap internal validation， net reclassification improvement （NRI）， and integrated discrimination improvement （IDI） were used to assess the predictive gain of sarcopenia. ResultsThe multivariate Cox regression analysis showed that presence of sarcopenia （hazard ratio ［HR］=3.385， 95% confidence interval ［CI］： 1.722 — 6.657， P<0.05）， older age （HR=1.036， 95%CI： 1.017 — 1.056， P<0.05）， elevated alkaline phosphatase （HR=1.006， 95%CI： 1.004 — 1.009， P<0.05）， elevated total bilirubin （HR=1.003， 95%CI： 1.001 — 1.005， P<0.05）， elevated potassium （HR=1.581， 95%CI： 1.160 — 2.155， P<0.05）， elevated serum creatinine （HR=1.015， 95%CI： 1.007 — 1.024， P<0.05）， and prolonged prothrombin time （HR=1.035， 95%CI： 1.015 — 1.055， P<0.05） were independent risk factors for 90-day mortality in ACLF patients， while elevated albumin （HR=0.885， 95%CI： 0.837 — 0.935， P<0.05） was an independent protective factor against 90-day mortality. MELD， MELD-Na， MELD 3.0， and COSSH-ACLF Ⅱ scores had an area under the ROC curve （AUC） of 0.569， 0.570， 0.632， and 0.659， respectively， for predicting the 90-day prognosis of ACLF patients， suggesting that these scores had unsatisfactory performance； after they were respectively combined with sarcopenia， the AUC was increased to 0.702， 0.687， 0.723， and 0.728， respectively. The DeLong test， NRI， and IDI analyses showed the combined models had significantly better predictive performance （all P<0.05）. ConclusionSarcopenia is an independent risk factor for 90-day mortality in patients with ACLF. Traditional scoring models have limited predictive performance for 90-day prognosis in ACLF patients， and the combination with sarcopenia significantly improves predictive value， suggesting that sarcopenia can be used as an important supplementary indicator for prognostic evaluation of ACLF in clinical practice.

Objective:To analyze the current status of clinical research registration on TCM prevention and treatment of malignant tumors in the Chinese Clinical Trail Registry (ChiCTR); To summarize its characteristics and shortcomings.Methods:Clinical studies on the TCM prevention and treatment for malignant tumors registered from the establishment of ChiCTR database to July 15, 2024 were retrieved. Excel 2019 software was used to sort out the data, including basic research information (registration time, registration number status, registration title, test organizer, research implementation location, etc.), design scheme (disease type, research type, intervention measures, sample size, blind method, etc.), research funding or material sources, as well as other information such as human specimen collection and recruitment of research objects. SPSS 27.0 software was used for frequency statistics.Results:A total of 891 registered studies were included, including 783 interventional studies and 108 observational studies; the areas with a large number of registrations were mainly Shanghai, Beijing, Guangdong Province, etc. ; the research funds mainly came from local finance; a total of 46 tumor diseases were involved in the study, with the largest number of lung cancer (209 items), followed by tumor-related syndromes (155 items), colorectal cancer (148 items), and breast cancer (136 items); the type of research design was mainly random parallel control; the main intervention measures were TCM decoction or herbal decoction pieces (373 items), and the dosage form was mostly decoction (216 items), followed by granules (94 items); single-blind or double-blind design was used in 217 registered trials; 663 registration trials involved the collection of human samples.Conclusions:The number of clinical research registrations on the TCM prevention and treatment for malignant tumors is increasing day by day. The shortcomings such as insufficient standardization of research design and lack of research transparency still exists. In the future, TCM researchers need to strengthen cooperation with international traditional medicine clinical trial registry, giving full play to the leading role of standardization of TCM trials, and using registration as a starting point to improve the quality of clinical research.

Chronic atrophic gastritis(CAG)is a precancerous lesion of gastric cancer,and its pathogenesis is complicated,with recurrent and prolonged symptoms.Starting from the view of stomach collaterals and sweat pores,the paper analyzed the pathogenesis of CAG,i.e.,stagnation and obstruction of sweat pores,and blood stasis obstructing stomach collaterals.Furthermore,this paper explored the efficacy of wind medicines in treating CAG by opening sweat pores and unblocking stomach collaterals.It is believed that wind medicines are pungent with warm nature,and have the actions of relieving exterior syndrome,regulating qi,elevating yang,unblocking collaterals and dissipating masses,which enable their efficacy on opening sweat pores and unblocking stomach collaterals.In the treatment of CAG,wind medicines are able to open the sweat pores,and the opening of sweat pores promotes the recovery of spleen-stomach function in lifting lucid yang and lowering turbid yin;wind medicines have the actions of directing herbs to the affected meridian or site,and assisting the other Chinese medicines to achieve satisfactory efficacies;wind medicines can also be used for drying dampness,and enhance the efficacy of removing dampness with the help of their actions of opening sweat pores.During the treatment of CAG,the combination of wind medicines can enhance the therapeutic effect of Chinese herbal medicine,and the exploration in this paper will provide reference for traditional Chinese medicine treatment of CAG in clinic.

Promoting the international acceptance of clinical studies about traditional Chinese medicine (TCM) interventions is a key strategy for internationalization of TCM. However, the complexities of TCM interventions—in terms of the theories, practice patterns, and components—pose challenges to the design and implementation of clinical studies that are well accepted by the international community. This article summarized the current status of clinical studies about TCM interventions that were published in international journals, explored underlying barriers hindering the international acceptance, and discussed potential strategies for future development.